Lead Claims Analyst

Lead and support the day-to-day work of a claims unit by investigating, reviewing, and resolving complex claims, appeals, inquiries, and payment inaccuracies. Ensure claims are payable or denied using policy and provider contract provisions, maintain documentation, and meet production and quality standards. Serve as the first point of escalation, monitor quality review accuracy to identify trends and systemic root causes, and help create workflows while training and mentoring claims analysts.